Arvig | Assistance Programs

Select the program(s) you want to participate in *

Select the program(s) you want to participate in:

Complete the following to participate in the programs selected above.
The information you enter must be the same information and format (first name, last name, address, etc.) that you used for USAC's application. If any of the information differs, your application will fail. Credits will not be applied and cannot be backdated.

Are you an existing Arvig customer? *

Are you an existing Arvig customer?

Please call 888.992.7844 to schedule an installation date for service.
Service must be active to enroll in the Lifeline Program.

Mailing Address

Street Address

Street Address Line 2

City

State

Zip Code

Arvig Account Number

This number is on your monthly bill.

Application ID

You received this number after you completed your application on the Lifeline website.

If necessary, do we have your permission to transfer your Lifeline benefit to Arvig? *

If necessary, do we have your permission to transfer your Lifeline benefit to Arvig?

First Name

Last Name

Phone Number

Last 4 Digits of Your Social Security Number

Email Address

Date of Birth *

Date of Birth

Address You Applied With on the Lifeline Website *

Street Address

Street Address Line 2

City

Zip Code

Tribal ID

If Applicable

Are you applying for a dependent? *

Are you applying for a dependent?

Dependent's First Name

Dependent's Last Name

If you are applying under a dependent, please enter the last 4 digits of their Social Security Number

Dependent's Date of Birth *

Dependent's Date of Birth

Dependent's Tribal ID

If Applicable

Agreement for Service

You are allowed to get one Lifeline benefit per household, not per person. Your household cannot get Lifeline from more than one company. You must give accurate and true information on this form and on all Lifeline-related forms or questionnaires. Lifeline is non-transferable to another person, even if they qualify. Please see the complete rules at lifelinesupport.org or contact the Lifeline Support Center at 800.234.9473.

I acknowledge and consent to the Lifeline Agreement for Service.

I understand that it is my responsibility to recertify with USAC if they contact me. All communications for recertifications will be directed and executed from USAC and are not prompted by Arvig.

Signature

The Economy internet plan is available in select areas. Call 888.992.7844 to learn about your other speed and pricing options.

To comply with Federal Communications Commission (FCC) Lifeline Program minimum service standards, any internet package that falls below the required threshold will be automatically upgraded. This upgrade may result in a higher monthly cost. Please contact customer service to review available offers and discounts.

Please verify that you are human

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